Provider Demographics
NPI:1578158101
Name:BANICHAR, BRITTANY JOI (NP)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:JOI
Last Name:BANICHAR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 ABERCORN ST
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-6782
Mailing Address - Country:US
Mailing Address - Phone:478-796-5731
Mailing Address - Fax:
Practice Address - Street 1:1707 WATSON BLVD
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-3606
Practice Address - Country:US
Practice Address - Phone:478-929-8030
Practice Address - Fax:478-929-8095
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN233561363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care